Long-term carotid plaque progression and the role of intraplaque hemorrhage: A deep learning-based analysis of longitudinal vessel wall imaging

作者：Yin Guo, Ebru Yaman Akçiçek, Daniel S. Hippe, SeyyedKazem HashemizadehKolowri, Xin Wang, Halit Akçiçek, Gádor Cantón, Niranjan Balu, Duygu Baylam Geleri, Tae‐Won Kim, Dean Shibata, Kaiyu Zhang, Beibei Sun, Xiaodong Ma, Marina S. Ferguson, Mahmud Mossa‐Basha, Thomas S. Hatsukami, Chun Yuan · 发表于：Journal of Cardiovascular Magnetic Resonance · 年份：2025 · DOI：10.1016/j.jocmr.2025.102670 · 被引用次数：2 · 研究领域：Cerebrovascular and Carotid Artery Diseases、Coronary Interventions and Diagnostics、Cardiovascular Health and Disease Prevention

BACKGROUND: Carotid atherosclerosis is a major contributor to the etiology of ischemic stroke. Although intraplaque hemorrhage (IPH) is known to increase stroke risk and plaque burden, its long-term effects on plaque dynamics remain unclear. This study aimed to evaluate the long-term impact of IPH on carotid plaque burden progression using deep learning-based segmentation on multi-contrast magnetic resonance vessel wall imaging (VWI). METHODS: 28 asymptomatic subjects with carotid atherosclerosis underwent an average of 4.7±0.6 VWI scans over 5.8±1.1 years. Deep learning pipelines were used to segment the carotid vessel walls and IPH. Bilateral plaque progression was analyzed using correlation coefficients and generalized estimating equations. Associations between IPH occurrence, IPH volume, and plaque burden (%WV) progression were evaluated using linear mixed-effect models. RESULTS: IPH was detected in 23/50 of the arteries at any time point. Of arteries without IPH at baseline, 11/39 developed new IPH that persisted, while 5/11 arteries with baseline IPH exhibited it throughout the study. Bilateral plaque growth was significantly correlated (r = 0.54, p<0.001), but this symmetry was weakened in cases with IPH (r = 0.1, p = 0.62). Moreover, IPH presence or development at any point was associated with a 2.3% absolute increase in %WV on average within the affected artery (p<0.001). The volume of IPH was also positively associated with increased %WV (p = 0.005). CONCLUSION: Dee...